1. Field of the Invention
This invention relates broadly to surgical devices. More particularly, this invention relates to implants for the fixation of bone fractures, particularly in long bones such as the radius and tibia.
2. State of the Art
Severe long bone fractures are often treated with plating. In plating, a relatively large incision is made at the location of the fracture, musculature and tendons are displaced from the bone to expose the bone surface, and a bone plate is fixedly attached to one or more pieces of the fractured bone in a manner which, ideally, supports and stabilizes the fracture for healing. Due to the relatively invasive nature of the procedure required to implant the plate, plating is generally reserved for fractures which cannot be treated with a less invasive method of immobilization.
Less complicated fractures are often treated with casting or wires. However, such conservative treatment may not provide the stabilization and support necessary for desirable recovery. Yet, the operative procedure of plating is often too invasive for the relative non-severity of the fracture. Moreover, conventional plating can result in tendon irritation and skin necrosis. As such, many of the less displaced fractures, and particularly metaphyseal fractures (fractures at the end of the long bones), remain undertreated.
By way of example, a Colles"" fracture, which results from compressive forces being placed on the distal radius bone, and which causes backward displacement of the distal fragment and radial deviation of the hand at the wrist, is treated with a dorsal plate when there is a significant degree of displacement. However, a less-displaced Colles"" fracture is commonly undertreated due to the hesitancy of physicians to prescribe operative and invasive treatment. If not properly treated, such a fracture results in permanent wrist deformity. It is therefore important to align the fracture and fixate the bones relative to each other so that proper healing may occur.
In addition, there is no minimally invasive procedure to treat fractures occurring at the metaphysis and that also provides the desired immobilization for such fractures.
Furthermore, there is no minimally invasive procedure to treat distal radius fractures that provides the stability generally obtained by more invasive procedures, such as open reduction and internal fixation.
It is therefore an object of the invention to provide a minimally invasive treatment which provides stabilization and support to long bone fractures.
It is another object of the invention to provide a minimally invasive treatment which provides stabilization and support to metaphyseal fractures.
It is a further object of the invention to provide a minimally invasive treatment which provides stabilization and support to fractures occurring at the metaphysis.
In accord with-these objects, which will be discussed in detail below, a fixation device is provided which includes a proximal nail portion and a distal plate portion, preferably horizontally and vertically offset relative to the nail portion by a neck portion, e.g., such that the device preferably has a shape of an elongate xe2x80x98Sxe2x80x99. The nail portion includes a tapered end which is flexible, and a relatively rigid distal portion larger in diameter. For treatment of distal radius fractures, the distal portion of the nail portion preferably includes two cortical screw holes, and the plate portion has a low, narrow profile and includes three longitudinally displaced peg holes, each of which is adapted to orient a peg in a different orientation from the others. The plate portion also includes a screw hole intended to receive a stabilization screw.
In use, a small incision is made in the skin, and the tapered end of the nail portion of the device is introduced percutaneously through the incision and through the fracture location into the medullary canal of the bone. The plate portion of the device is then maneuvered against a surface of the bone, and a stabilization screw-is introduced to drive the plate against the bone. Holes are drilled through the peg holes and into the bone, and pegs are introduced through the holes to provide stabilization and support for subchondral fragments. Optionally, cortical screws may be provided into the diaphyseal portion of the bone and into the cortical screw holes to further fixate the device.
The fixation device permits a minimally invasive treatment of long bone fractures that may otherwise be undertreated.
Additional objects and advantages of the invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the provided figures.